(Stroke. 2000;31:946.)
© 2000 American Heart Association, Inc.
Original Contributions |
Transient and Permanent Resolution of Ischemic Lesions on Diffusion-Weighted Imaging After Brief Periods of Focal Ischemia in Rats
Correlation With Histopathology
From the Departments of Neurology (F.L., T.O., M.F.) and Radiology (C.H.S., M.F.), UMass Memorial Health Care and University of Massachusetts Medical School, Worcester, Mass; the Departments of Pathology (Neuropathology) (K-F.L.) and Anesthesiology (J.D.F.), Henry Ford Hospital, Detroit, Mich; and the Departments of Biomedical Engineering (M.D.S., C.H.S.) and Chemistry & Biochemistry (C.H.S.), Worcester Polytechnic Institute, Worcester, Mass.
Correspondence to Fuhai Li, MD, Department of Neurology, UMass Memorial Health Care, 119 Belmont St (Memorial Campus), Worcester, MA 01605. E-mail fhli{at}wpi.edu
Background and Purpose—The early ischemic lesions demonstrated by diffusion-weighted imaging (DWI) are potentially reversible. The purposes of this study were to determine whether resolution of initial DWI lesions is transient or permanent after different brief periods of focal brain ischemia and to evaluate histological outcomes.
Methods—Sixteen rats were subjected to 10 minutes (n=7) or 30 minutes (n=7) of temporary middle cerebral artery occlusion or sham operation (n=2). DWI, perfusion-weighted imaging (PWI), and T2-weighted imaging (T2WI) were performed during occlusion; immediately after reperfusion; and at 0.5, 1.0, 1.5, 12, 24, 48, and 72 hours after reperfusion. After the last MRI study, the brains were fixed, sectioned, stained with hematoxylin and eosin, and evaluated for neuronal necrosis.
Results—No MRI or histological abnormalities were observed in the sham-operated rats. In both the 10-minute and 30-minute groups, the perfusion deficits and DWI hyperintensities that occurred during occlusion disappeared shortly after reperfusion. The DWI, PWI, and T2WI results remained normal thereafter in the 10-minute group, whereas secondary DWI hyperintensity and T2WI abnormalities developed at the 12-hour observation point in the 30-minute group. Histological examinations demonstrated neuronal necrosis in both groups, but the number of necrotic neurons was significantly higher in the 30-minute group (95±4%) than in the 10-minute group (17±10%, P<0.0001).
Conclusions—Transient or permanent resolution of initial DWI lesions depends on the duration of ischemia. Transient resolution of DWI lesions is associated with widespread neuronal necrosis; moreover, permanent resolution of DWI lesions does not necessarily indicate complete salvage of brain tissue from ischemic injury.
Editorial Comment
Correlation With Histopathology
Department of Neurology, Washington University School of Medicine, St Louis, Missouri
Department of Radiology, University of North Carolina, Chapel Hill, North Carolina
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